The Seton Family of Hospitals, a not-for-profit organization, is the leading provider of healthcare services in Central Texas.Seton is building for the future providing ´Healthcare that Works and Leaves No One Behind.´
SMCH Case Management Responsibilities 1. Formulates and promotes continuity of care assuring appropriate medical treatments, processes, and utilization of resources based upon established criterion. Supports management of concurrent review, discharge planning processes, social services, home care and other post discharge continuity of care needs. 2. Consistent with professional standards integrates patient/family preferences and values into a quality supportable plan for their care across the continuum. Advocates for resources and removal of barriers for the promotion of outcomes that are consistent with patient values and preferences across the continuum. Conducts ongoing research to build a network of resources and alternative health care services that can better meet patient/family continuum of care needs. 3. Collaborates with the PI program by gathering sentinel events and target diagnosis data. Stays current with trends/research in professional field. Makes suggestions for improvement of current processes and practice trends based on research. 4. Collaborates with physicians, RN Care Manager and other team members in the planning, implementation and evaluation of the continuum care needs for patients/families. Collaborates with physicians, nursing directors/clinical managers and department directors to improve practice issues that impact continuum of care needs of the patient. 5. Participates in providing education support for newly hired staff persons within the department. Mentors interdisciplinary healthcare team in critical thinking processes essential to continuum of care issues. 6. Coordinates patient education as needed to address continuum needs. Collaborates with social worker to educate patients, families on discharge planning processes. 7. Facilitates appropriate lengths of stay and reimbursement for all hospital admissions in accordance with goals and objectives established in the utilization management plan. Facilitates patient movement to the appropriate (acuity) level of care including observation status through collaboration with patient/family, multidisciplinary team, and third party payors. Minimum Qualifications Two (2) years of nursing experience in an acute care or surgical setting is required. Experience in utilization review, knowledge of managed care rules and regulations, government policy rules and regulations, and computer skills are preferred. Registered Nurse licensed to practice in Texas is required. Preferred Qualifications Hospital Case Management experience preferred. Skills Physical Demands Lights (requires lifting 20 lbs, with frequent carrying of up to 20 lbs) Balancing:............Occasionally Bending:...............Occasionally Carrying:...............Occasionally Climbing:.............Occasionally Crawling:..............Rarely Crouching:............Occasionally Fine Dexterity:.......Continuously Foot Controls:.......Occasionally Handing:..............Frequently Hearing:...............Continuously Kneeling:.............Occasionally Lifting:..................Occasionally Pushing Pulling:....Occasionally Reaching:............Occasionally Sitting:...................Continuously Standing:..............Occasionally Talking:................Continuously Twisting:..............Occasionally Vision:..................Continuously Walking:...............Occasionally Work Environment Involves no exposure to blood borne pathogens as part of duties Supervision Received CASE MANAGEMENT PROGRAM MANAGER Supervision Exercised N/A Physical Other NONE Other Functions 1. Other duties as assigned.